Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[Treatment] Stuck in Timed Mode?
#1
Stuck in Timed Mode?
RT here, just this area isnt my field of expertise, I  do respiratory rehab and specialize in fibrosis treatments.

So with that said, I'm also on O2 from Covid Pneumonia lung scarring (but its slowly reversing due to Chinese medicine).

I had covid abit over a year ago, and had pretty bad scarring.  3w in the hospital, lost 25pds of muscle (used to be a big weight lifter).  As if that wasnt bad enough, 2w later threw a PE and came that close to meeting my maker. Released on a Walker, 750ML lung capacity, 3l rest, 6L walking.

Over the past 1.25 years, while daytime O2 is dropping (now 0 during daytime, only for exertion) , I've had to crank up my overnight O2 to compensate for hypoxic events (2L > 4L).  Except now its getting bad with bradycardia as well, and so did a home study, as I have severe hyper-vigilance, have to take trazadone, earplugs and white noise to sleep.  No way would I ever sleep at a sleep study wired up like a marionette.

Results were 13.9 AHI, no Central, just OSA, and with Insomnia didnt have to take a follow up test (insurance wise).  I really wanted a BiPap for more natural breathing, and Obviously insurance won't cover it.   One of my fellow RTs Found me an air curve 10 St model with only 600 hours on it for 275 bucks.    Just couldn't pass that up.

First night in S mode was brutal AHI of 15.7 and my O2 looked like crap.  My overnight oximetry was better without the machine. Great, so I've got treatment CSA as if OSA wasnt enough.  (although I did read a post here claiming that may resolve, since I'm new to the device)

So I figured I'd try Timed mode, and see if that helped.  Used BR of 15, Ti Min 1s  TiMax 2s. Moved IPAP from 10>12) EPAP is 4.  O2 is still at 4L

So I programmed it all up, and AHI dropped to .7 overnight, and my O2 oximetry confirmed it.  Success.

So now finally to my question (and no, I havent gotten oscar to download the more finite information yet).  It seems when I wake up middle of night, or normal wake up, its in timed mode, not spontaneous so my inhale is cut short.  I cant seem to even get it back to Spontaneous again .  Its like stuck in timed mode. so I'm breathing, but getting cut off at that 2s mark.  Testing during day I'd played making TiMax much longer Over 3s, and it was difficult to get ePAP to trigger, even with trigger very low.  It would stay in IPAP until TiMax.

I think with current settings TiMAX is 2.7s max.  Tonight I'll bump to 2.5s and see how that works.  But the big question is why is it stuck in Timed Mode?

Thank you, great board here, glad I found it.
Post Reply Post Reply
#2
RE: Stuck in Timed Mode?
From the Clinicians Manual:
Code:
S mode
In S mode, you may set two treatment pressures-–one for inspiration (IPAP) and one for expiration
(EPAP). The device senses when the patient is inhaling and exhaling and supplies the pressures
accordingly. The difference between IPAP and EPAP levels helps determine the tidal volume.

ST mode
In ST mode, the device augments any breath initiated by the patient, but will also supply additional
breaths should the patient breath rate fall below the set "backup" breath rate.

T mode
In T mode, a fixed breath rate and a fixed inspiration/expiration time are supplied regardless of
patient effort.
Once you set a mode, it stays in that mode.

I suspect you would want ST mode.

You can get a pdf copy of the clinicians Manual by clicking on 'CPAP Setup Manuals' and following the directions there; The AirCurve 10 ST is in part 3.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Post Reply Post Reply
#3
RE: Stuck in Timed Mode?
JeffPack, please download the free OSCAR software and post a chart so we can see what is going on and get a more precise idea of your settings. Your machine is probably and Aircurve 10 ST and the mode you will want to use is ST mode which supports both spontaneous breasting and a timed backup. It is very unusual for anyone to really require a full-time Timed mode. By changing to ST, your machine will allow for spontaneous triggering of IPAP and give you a timed backup when spontaneous breathing is not detected withing the set BPM. The chart will also let us evaluate the presence of CA that we may need to address. There are links to tutorials in my signature that describe how to organize an OSCAR screenshot and attach an image for us to review.

In addition to all of this, you may want to take a look at the Oxygen Bleed with CPAP wiki. I wrote that as an elementary approach to helping members understand fraction of inspired oxygen (FiO2) and how to titrate for supplemental oxygen. http://www.apneaboard.com/wiki/index.php..._with_CPAP
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#4
RE: Stuck in Timed Mode?
(03-05-2023, 01:28 AM)pholynyk Wrote: From the Clinicians Manual:
Code:
S mode
In S mode, you may set two treatment pressures-–one for inspiration (IPAP) and one for expiration
(EPAP). The device senses when the patient is inhaling and exhaling and supplies the pressures
accordingly. The difference between IPAP and EPAP levels helps determine the tidal volume.

ST mode
In ST mode, the device augments any breath initiated by the patient, but will also supply additional
breaths should the patient breath rate fall below the set "backup" breath rate.

T mode
In T mode, a fixed breath rate and a fixed inspiration/expiration time are supplied regardless of
patient effort.
Once you set a mode, it stays in that mode.

I suspect you would want ST mode.

You can get a pdf copy of the clinicians Manual by clicking on 'CPAP Setup Manuals' and following the directions there; The AirCurve 10 ST is in part 3.

I misspoke, I'd meant  "added" T mode,  so ST mode, but its stuck in timed mode after awhile it seems.  Even when I wake up, it takes several good breaths to force it to go Spontaneous again.  One time waking up at night, I stopped the machine and restarted sleep and it was stuck in timed mode again and wouldnt activate on a breath, even though trigger is set very high.

And yes, I have the clinical manual.  I guess I really need to DL data then, I'd just figured this was something easy to answer.
Post Reply Post Reply
#5
RE: Stuck in Timed Mode?
Ah... I think I see what you mean... You set it for ST mode, but if you wake up it is running at the backup rate as if in Timed mode...

I think you may have set your backup rate too high, so that it is higher than your sleeping respiration rate. For example, my vAuto reports my RR is 16 - but that's an average, so if I were to slow down, it would drop in the backup rate of 15 (if I had such a thing in vAuto mode). I think that's what's happening to you. I don't know what value you should use; I think it will be a compromise between sufficient O2 saturation and the Spontaneous Cycle value. OSCAR will display your RR in a graph as well as the statistical values. That should help you seta better backup rate.

I'm not an RT; I just have to guess at how the machines work so I can write the OSCAR code to show what's happening.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Post Reply Post Reply
#6
RE: Stuck in Timed Mode?
(03-05-2023, 04:12 PM)pholynyk Wrote: Ah... I think I see what you mean... You set it for ST mode, but if you wake up it is running at the backup rate as if in Timed mode...

I think you may have set your backup rate too high, so that it is higher than your sleeping respiration rate. For example, my vAuto reports my RR is 16 - but that's an average, so if I were to slow down, it would drop in the backup rate of 15 (if I had such a thing in vAuto mode). I think that's what's happening to you. I don't know what value you should use; I think it will be a compromise between sufficient O2 saturation and the Spontaneous Cycle value. OSCAR will display your RR in a graph as well as the statistical values. That should help you seta better backup rate.

I'm not an RT; I just have to guess at how the machines work so I can write the OSCAR code to show what's happening.

This unit doesn't have backup rate,I don't know why. But I think on mine it's respiratory rate.  And I figured that played in as you described. But even with that said,I should be able to kick it back to spontaneous  when I wake. 


Was at 15, I've dropped it, but don't recall to what right now. But it seems be a balance of respiratory rate and ti min max.  O2 sats have been fine

Ty!!
Post Reply Post Reply
#7
RE: Stuck in Timed Mode?
The recommended backup rate is 3 breaths per minute less than normal.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#8
RE: Stuck in Timed Mode?
(03-05-2023, 06:30 PM)Sleeprider Wrote: The recommended backup rate is 3 breaths per minute less than normal.

I dropped RR to 13, upped Ti Max  to 3.1, and I think I'm pretty close.  I really dont notice it anylonger.  O2 sats remained fine (average 95% overnight).

Tonight going to back down O2 delivery and review sats in the morning.  I'm curious if I can get back to that therapeutic dosage of 2L pre all the pre apnea treatment fun.
Post Reply Post Reply
#9
RE: Stuck in Timed Mode?
With ST, most of the battle is getting it to sync properly with your spontaneous breathing. Good changes.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#10
RE: Stuck in Timed Mode?
the resmed clinical guide wasn't very clear on the association or Respiratory Rate with the Ti settings.  you folks helped me figure that one, ty.

Although any idea why mine is Respiratory rate instead of Backup Rate?  My unit must be an older one I'd have to guess.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  AHI stuck around 10 PercyA 3 193 02-28-2024, 08:50 PM
Last Post: Sleeprider
  Difference between S-Mode and VAUTO mode - Aircurve MrIvanDrago 3 250 02-27-2024, 02:28 PM
Last Post: Sleeprider
  Stuck SD card Old Steve 6 444 01-16-2024, 03:40 PM
Last Post: Big Guy
  [CPAP] CPAP in Silent Mode and Mask Useful life meaning aconti 5 459 12-17-2023, 01:45 PM
Last Post: aconti
  Changed my mother over to APAP Mode: Phaleronic 2 382 12-11-2023, 05:17 PM
Last Post: Phaleronic
  [Equipment] ResMed S9 Elite stuck "erasing all data", bricked User3001 0 271 11-17-2023, 12:03 PM
Last Post: User3001
  Resmed 11 autoset For Her mode help! HMG7450 10 683 11-15-2023, 10:06 AM
Last Post: OpalRose


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.